A COST EFFECTIVE APPROACH FOR FACIAL
REHABILITATION WITH DENTAL IMPLANTS

Robert, a 49-year-old journalist came to Pi for an opinion on his smile. His profession required frequent face-to-face interviews.

His chief complaints were the embarrassment he experienced when smiling, painful chewing, very poor esthetics and highly mobile teeth. He wrote in his medical history, “It would be nice to smile again”. Robert was in a severe auto accident in 1980, which left him with a chronic painful condition in his neck, his back and his jaws.

Robert’s initial clinical examination noted multiple fractured teeth, extensive dental caries, apical abscesses, and extruded teeth, which created a severe malocclusion. There was a heavy plaque and calculus accumulation, which combined with smoking, contributed to advanced periodontal disease. At his initial visit, he smoked one pack of cigarettes a day, but desired to stop. Robert was advised of the effects of smoking, not only on his general health, but also on his dental condition. He was strongly advised to stop. Robert did admit he was “a very bad dental patient” due to his high level of anxiety.

Historically, extensive periodontal therapy followed by prosthodontic treatment may have been indicated to maintain and restore Robert’s natural dentition. However, with all the clinical findings and the current condition of the patient’s dentition, traditional dental treatment had a poor prognosis. With his advanced periodontal disease and his poor compliance, orthodontics to improve the dental malocclusion was not a viable option.

Robert was presented with a treatment plan addressing all his concerns in an expedient manner. Cost was a consideration for the full mouth reconstruction. Some doctors would recommend less expensive implant prosthetic treatment using an implant overdenture. At Pi Dental Center we have found that patients are rarely satisfied with the removable implant overdenture as they are with the fixed implant prostheses. We found that there are many additional visits, as well as added costs associated with maintenance of the overdentures. Recent studies have collaborated our findings (see abstract).

The philosophy at Pi Dental Center is to provide patients with the most effective and efficient approach to solving their dental problems. The Teeth In A Day™ procedure is an excellent alternative for patients with a failing dentition who need to make the transition to an implant supported prosthesis. Historically, it would take several months or even years to see the benefits of implant treatment. Fifteen years of research pioneered at Pi Dental Center has enabled patients to enjoy the benefits of immediately loading the implant-supported teeth on the same day that their decayed teeth are removed and the implants installed. This accelerates the entire clinical process.

The early research for Teeth In A Day™ was accomplished in patients where larger numbers of implants were placed to provide a very predictable solution for prosthesis stability. Recently, studies have been published that show comparable predictability using fewer implants. The latter may prove to be a more cost effective treatment approach for patients in need of implant-reconstruction.

For Robert’s treatment all the periodontally compromised teeth were extracted, six implants were placed in the maxillary arch, four implants were placed in the mandibular arch and prostheses for both arches were put into immediate function following the Teeth In A Day™ protocol. While the patient was encouraged to adhere to a soft diet for the first three months, the temporary teeth proved to be much stronger than Robert’s natural teeth.

Pre-treatment views prior to Teeth In An Day™

The esthetic improvements were immediate. Three months after the implant placement the bone healing had stabilized and the final implant reconstructions were delivered.

The patient went through a complete makeover to improve his overall esthetics. Dr. George Zavitsanos, a board certified plastic surgeon, provided improved facial esthetics by surgically correcting the deviation in Robert’s nose in conjunction with multiple soft tissue enhancements. Following facial surgery healing and the Teeth In A Day™ treatment, Robert agreed to a style makeover and experienced his first hair cut since 1969. A new prescription for corrective lenses offered yet another cosmetic improvement with his stylish new glasses. Robert’s satisfaction with the Teeth In A Day™ procedure is extremely high. He has noticed a dramatic improvement in his psychological well-being and has found it easy to smile and be more outgoing. As a news journalist for a Washington, DC newspaper, he feels more comfortable at press conferences in the highly political public eye.

From a dental standpoint, the periodontal disease has been eliminated and the patient now has a completely healthy, functional, stable and esthetically pleasing reconstruction.